Common use of ELECTION TO PURCHASE FORM Clause in Contracts

ELECTION TO PURCHASE FORM. (To be Executed by the Registered Holder in Order to Exercise Warrants Represented by the Warrant Certificate on the reverse hereof) To: MAGNUM HUNTER RESOURCES, INC. The undersigned Registered Holder hereby irrevocably elects to exercise _____________ Warrants, represented by the Warrant Certificate on the reverse hereof, and to purchase the securities issuable upon exercise of such Warrants, and requests that certificates for such securities be issued in the name of: --------------------------------------------------------------- (Please print or type your Name and Address) --------------------------------------------------------------- (Please print or type your Social Security or Federal Tax Identification Number) and, if such number of Warrants shall not be all the Warrants represented by the Warrant Certificate on the reverse hereof, that a new Warrant Certificate for the balance of such Warrants be registered in the name of, and delivered to the Registered Holder at the address stated below. The Registered Holder understands and agrees that the Company may require Registered Holders to establish their exemptions from backup withholding or to arrange for payment of backup withholding. Dated: --------------------------------- Name of holder of the Warrant Certificate: ------------------------------------- (Please Print or Type) Address: ----------------------------------------------------------------------- Signature: --------------------------------------------------------------------- NOTICE: The above signature must correspond with the name as written upon the face of the Warrant Certificate on the reverse hereof in every particular, without alteration or enlargement or any change whatsoever, or if signed by any other person the Form of Assignment hereon must be duly executed and if any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which the Warrant Certificate on the reverse hereof is registered, the signature of the holder hereto must be "medallion" guaranteed.

Appears in 1 contract

Samples: Warrants Agreement (Magnum Hunter Resources Inc)

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ELECTION TO PURCHASE FORM. (To be Executed by the Registered Holder in Order to Exercise Warrants Represented by the Warrant Certificate on the reverse hereof) To: MAGNUM HUNTER RESOURCES, INC. The undersigned Registered Holder hereby irrevocably elects to exercise _____________ Warrants, represented by the Warrant Certificate on the reverse hereof, and to purchase the securities issuable upon exercise of such Warrants, and requests that certificates for such securities be issued in the name of: --------------------------------------------------------------- (Please print or type your Name and Address) --------------------------------------------------------------- (Please print or type your Social Security or Federal Tax Identification Number) and, if such number of Warrants shall not be all the Warrants represented by the Warrant Certificate on the reverse hereof, that a new Warrant Certificate for the balance of such Warrants be registered in the name of, and delivered to the Registered Holder at the address stated below. The Registered Holder understands and agrees that the Company may require Registered Holders to establish their exemptions from backup withholding or to arrange for payment of backup withholding. Dated: --------------------------------- Name of holder of the Warrant Certificate: ------------------------------------- (Please Print or Type) Address: ----------------------------------------------------------------------- Signature: --------------------------------------------------------------------- NOTICE: The above signature must correspond with the name as written upon the face of the Warrant Certificate on the reverse hereof in every particular, without alteration alternation or enlargement or any change whatsoever, or if signed by any other person the Form of Assignment hereon must be duly executed and if any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which the Warrant Certificate on the reverse hereof is registered, the signature of the holder hereto must be "medallion" guaranteed.

Appears in 1 contract

Samples: Warrants Agreement (Magnum Hunter Resources Inc)

ELECTION TO PURCHASE FORM. (To be Executed If you, the Holder, want to exercise the Class A Warrants represented by this Certificate, fill in the Registered Holder in Order to Exercise form below. I or we, the registered owner of the Class A Warrants Represented represented by the Warrant this Certificate on the reverse hereof) To: MAGNUM HUNTER RESOURCES, INC. The undersigned Registered Holder hereby irrevocably elects to exercise ________________________________ WarrantsClass A Warrants for the purchase of _________________________________ shares or other securities or property of Common Stock of Vishay Intertechnology, represented by Inc., at the Warrant Certificate price and on the reverse hereof, terms and to purchase conditions specified in the securities issuable upon exercise of such Warrants, Class A Warrants and requests request that certificates for the shares of Common Stock hereby purchased (and any securities or other property issuable or transferable upon such securities exercise) be issued in the name ofof and delivered to: --------------------------------------------------------------- ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ (Please print Print or type your Name name, address and Address) --------------------------------------------------------------- (Please print zip code and social security or type your Social Security or Federal Tax Identification Numbertax ID number of owner) and, if such number of Class A Warrants shall not be constitute all of the Class A Warrants represented by the Warrant Certificate on the reverse hereofthis Certificate, that a new Class A Warrant Certificate of like tenor and date for the balance of such the Class A Warrants represented hereby be registered in the name of, and delivered to the Registered Holder at the address stated belowundersigned. The Registered Holder understands and agrees that the Company may require Registered Holders to establish their exemptions from backup withholding or to arrange for payment Number of backup withholding. Dated: --------------------------------- Name Class A Warrants represented by this Certificate ________ Number of holder of the Warrant Certificate: ------------------------------------- Class A Warrants being exercised ________ Balance ________ Date:____________________________ Signed:________________________________ (Please Print or Type) Address: ----------------------------------------------------------------------- Signature: --------------------------------------------------------------------- NOTICE: The above signature must correspond with the Signed exactly as your name as written upon the face of the Warrant Certificate appears on the reverse hereof in every particular, without alteration or enlargement or any change whatsoever, or if signed by any other person the Form of Assignment hereon must be duly executed and if any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which the Warrant Certificate on the reverse hereof is registered, the signature of the holder hereto must be "medallion" guaranteed.this Warrant)

Appears in 1 contract

Samples: Warrant Agreement (Vishay Intertechnology Inc)

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ELECTION TO PURCHASE FORM. (To be Executed If you, the Holder, want to exercise the Class B Warrants represented by this Certificate, fill in the Registered Holder in Order to Exercise form below. I or we, the registered owner of the Class B Warrants Represented represented by the Warrant this Certificate on the reverse hereof) To: MAGNUM HUNTER RESOURCES, INC. The undersigned Registered Holder hereby irrevocably elects to exercise ________________________________ WarrantsClass B Warrants for the purchase of _________________________________ shares or other securities or property of Common Stock of Vishay Intertechnology, represented by Inc., at the Warrant Certificate price and on the reverse hereof, terms and to purchase conditions specified in the securities issuable upon exercise of such Warrants, Class B Warrants and requests request that certificates for the shares of Common Stock hereby purchased (and any securities or other property issuable or transferable upon such securities exercise) be issued in the name ofof and delivered to: --------------------------------------------------------------- ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ (Please print Print or type your Name name, address and Address) --------------------------------------------------------------- (Please print zip code and social security or type your Social Security or Federal Tax Identification Numbertax ID number of owner) and, if such number of Class B Warrants shall not be constitute all of the Class B Warrants represented by the Warrant Certificate on the reverse hereofthis Certificate, that a new Class B Warrant Certificate of like tenor and date for the balance of such Warrants the Class A Warrantes represented hereby be registered in the name of, and delivered to the Registered Holder at the address stated belowundersigned. The Registered Holder understands and agrees that the Company may require Registered Holders to establish their exemptions from backup withholding or to arrange for payment Number of backup withholding. Dated: --------------------------------- Name Class B Warrants represented by this Certificate ________ Number of holder of the Warrant Certificate: ------------------------------------- Class B Warrants being exercised ________ Balance ________ Date:_____________________________ Signed:__________________________________ (Please Print or Type) Address: ----------------------------------------------------------------------- Signature: --------------------------------------------------------------------- NOTICE: The above signature must correspond with the Signed exactly as your name as written upon the face of the Warrant Certificate appears on the reverse hereof in every particular, without alteration or enlargement or any change whatsoever, or if signed by any other person the Form of Assignment hereon must be duly executed and if any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which the Warrant Certificate on the reverse hereof is registered, the signature of the holder hereto must be "medallion" guaranteed.this Warrant)

Appears in 1 contract

Samples: Warrant Agreement (Vishay Intertechnology Inc)

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